在ADHD初始多模式治疗后,行为疗法的有效性降低
Marcela C Ramos1,2, Jennifer Piscitello1,2, Emily Robertson2
1Department of Psychology, Florida International University, Miami, FL 33199.
Evidence-based practice in child and adolescent mental health
|August 18, 2025
概括
建议在治疗儿童注意力缺陷/多动障碍 (ADHD) 药物治疗之前开始行为治疗. 最初的药物治疗可能会降低后来对ADHD的行为治疗的有效性,影响自我调节能力.
科学领域:
- 儿童心理学 儿童心理学
- 神经发育障碍 神经发育障碍
- 行为治疗是一种行为疗法.
背景情况:
- 儿童注意力缺陷/多动症 (ADHD) 治疗通常涉及行为疗法和精神兴奋剂,通常是联合的.
- 治疗ADHD的最佳顺序尚不清楚,新出现的证据支持在药物治疗之前进行行为干预.
- 开始对ADHD进行行为治疗的好处背后的机制尚未完全理解.
研究的目的:
- 通过减少ADHD儿童自我调节技能发展的机会,调查心理兴奋剂降低行为疗法的有效性假设.
- 探索治疗顺序对儿童ADHD人口行为结果的影响.
主要方法:
- 进行了一项三重掩盖的AB/BA交叉研究,对248名被诊断患有ADHD的儿童进行了研究.
- 参与者接受了3周的强化行为疗法加药 (COMB) 或行为疗法加安慰剂 (BT),然后交叉到替代条件.
- 基于药物状态和治疗顺序,在娱乐场所的行为观察被系统地分析.
主要成果:
- 开始用药物治疗 (COMB) 导致后续行为治疗的疗效降低,当药物被取消时.
- 儿童在开始使用COMB后,与开始单独使用BT相比,在未服用药物时表现出明显更多的不良行为.
- 早期药物暴露似乎会在药物停止后对行为功能产生负面影响.
结论:
- 通过综合方法 (行为疗法和药物) 开始ADHD治疗,当药物后来被取消时,可能会对行为产生不利影响.
- 这些发现支持当前的临床指南,建议仅用行为疗法开始ADHD治疗,并根据需要添加药物.
- 这种序列可能会保护或增强孩子发展和练习自我调节技能的能力.
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